Patients with a history of traumatic brain injury may present to the emergency department with the complaint of changing functional status, including psychomotor slowing, cognitive decline, change in gait, and loss of continence. An evaluation for possible infectious or metabolic causes must be undertaken, but a CT scan of the head is critical to exclude posttraumatic hydrocephalus.2223 A CT scan revealing periventricular lucency, diminishing sulci, and dilatation of the ventricles suggests posttraumatic hydrocephalus.23 Consultation with a neurosurgeon for appropriate treatment options, such as shunting, should be undertaken.
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